Quinine: Difference between revisions
| Line 67: | Line 67: | ||
===Serious=== | ===Serious=== | ||
*Cinchonism | *Cinchonism | ||
*QT prolongation | *[[QT prolongation]] | ||
*Torsades de pointes | *[[Torsades de pointes]] | ||
*Anaphylaxis | *[[Anaphylaxis]] | ||
*Angioedema | *[[Angioedema]] | ||
*Bronchospasm | *Bronchospasm | ||
*Thrombocytopenia | *[[Thrombocytopenia]] | ||
*TTP/HUS | *[[TTP]]/[[HUS]] | ||
*Hemolytic anemia | *Hemolytic anemia | ||
*Black water fever | *Black water fever | ||
*Stevens-Johnson syndrome | *[[Stevens-Johnson syndrome and toxic epidermal necrolysis]] | ||
*Intestinal nephritis | *Intestinal nephritis | ||
*Renal impairment | *Renal impairment | ||
| Line 82: | Line 82: | ||
*Leukopenia | *Leukopenia | ||
*Neutropenia | *Neutropenia | ||
*DIC | *[[DIC]] | ||
*Hypoglycemia | *Hypoglycemia | ||
* | *[[Myasthenia gravis]] exacerbation | ||
*Lupus | *[[Lupus]] | ||
*Optic neuritis | *[[Optic neuritis]] | ||
*Blindness | *Blindness | ||
*Deafness | *Deafness | ||
| Line 108: | Line 108: | ||
*Diarrhea | *Diarrhea | ||
*Abdominal pain | *Abdominal pain | ||
*Photosensitivity | *Photosensitivity | ||
==Pharmacology== | ==Pharmacology== | ||
Revision as of 23:39, 14 April 2015
General
- Type: Antimalarial
- Dosage Forms: PO 324 (IM and IV formulations available outside US)
- Common Trade Names: Qualaquin
Adult Dosing
Malaria
- 648 mg PO Q8h x 7 days
- See CDC Recommendations for full treatment recommendations
Babesiosis
- 648 mg PO q6-8h x7-10 days
- Use with Clindamycin
Pediatric Dosing
Malaria
- 30 mg/kg/day PO q8h x 3-7 days
- Max: 648 mg/dose
- See CDC Recommendations for full treatment recommendations
Babesiosis
- 8 mg/kg PO q8h x 7-10 days
- Max: 648 mg/dose
- Use with Clindamycin
Special Populations
- Pregnancy Rating: C
- Lactation: Probably safe
- Renal Dosing
- Adult
- Severe chronic renal failure: 648 mg PO x 1 then 324 mg PO q12h
- If on HD give after dialysis
- Pediatric
- Not defined
- Adult
- Hepatic Dosing
- Adult and Pediatric
- No adjustment for Child-Pugh Class A or B
- Avoid in Child-Pugh Class C
- Adult and Pediatric
Contraindications
Black Box Warnings
General
- Allergy to class/drug
- Allergy to mefloquine or quinidine
- Black water fever
- ITP/TTP/HUS
- Thrombocytopenia
- Glucose-6-Phosphate Deficiency (G6PD)
- Myasthenia gravis
- Optic neuritis
- QT prolongation/Congenital long QT syndrome
- Electrolyte abnormalities
- Bradycardia
- Ventricular arrhythmias
- CHF
- Recent MI
Caution
- Torsades de pointes
- Atrial fibrillation/Atrial flutter
- Pregnancy
- Hepatic impairment
Adverse Reactions
Serious
- Cinchonism
- QT prolongation
- Torsades de pointes
- Anaphylaxis
- Angioedema
- Bronchospasm
- Thrombocytopenia
- TTP/HUS
- Hemolytic anemia
- Black water fever
- Stevens-Johnson syndrome and toxic epidermal necrolysis
- Intestinal nephritis
- Renal impairment
- Hepatitis
- Leukopenia
- Neutropenia
- DIC
- Hypoglycemia
- Myasthenia gravis exacerbation
- Lupus
- Optic neuritis
- Blindness
- Deafness
Common
- Cinchonism
- Headache
- Vasodilation
- Diaphoresis
- Nausea/Vomiting
- Tinnitus
- Impaired hearing
- Vertigo
- Visual impairment
- Fever
- Flushing
- asthenia
- Rash
- Pruritus
- Urticaria
- Diarrhea
- Abdominal pain
- Photosensitivity
Pharmacology
- Half-life: 9-12 hours
- Metabolism: Liver 80%, CYP450
- Excretion: Urine
- Mechanism of Action: Unknown
See Also
Sources
- Epocrates